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202500044
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1/3/2025 4:16:03 PM
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1/3/2025 4:16:02 PM
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202500044
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202500044 <br />NOMINATION OF [CONSERVATOR AND/OR GUARDIAN] (OPTIONAL) <br />If it becomes necessary for a court to appoint a [conservator and/or guardian] of my estate or <br />[guardian] of my person, I nominate the following person(s) for appointment: <br />Name of Nominee for [conservator and/or guardian] of my estate: <br />Nominee's Address: <br />Nominee's Telephone Number: <br />Name of Nominee for [guardian] of my person: <br />Nominee's Address: <br />Nominee's Telephone Number: <br />RELIANCE ON THIS POWER OF ATTORNEY <br />Any person, including my agent, may rely upon the validity of this power of attorney or a copy <br />of it unless that person knows it has terminated or is invalid. <br />SIGNATURE AND ACKNOWLEDGMENT <br />S. CHITT <br />20 N. Gunbarrel Rd. <br />Grand Island, NE 68801 <br />(308) 379-8421 <br />Date <br />STATE OF NEBRASKA ) <br />) ss: <br />COUNTY OF HALL ) <br />This document was acknowledged before me on this c:?r' day of March, 2020 by <br />Jacquelin S. Chitty. <br />YU6A444,44 <br />NO ARY PUBLIC <br />GENERAL NOTARY - State of Nebraska <br />KEVIN A. BROSTROM <br />My COMM. Exp, September25, 2022 <br />
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